MEDICARE: UNIVERSITY SPINAL CARE CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIROPRACTOR0007001	FL

General Provider Information

NPI Number	:	1811174253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY SPINAL CARE CENTER

Provider Business Mailing Address
First Line	:	8441 HONORE AVE
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34201
Country	:	US
Telephone Number	:	941-360-3434
Fax Number	:	941-360-3433

Provider Business Practice Location Address
First Line	:	8441 HONORE AVE
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34201
Country	:	US
Telephone Number	:	941-360-3434
Fax Number	:	941-360-3433

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RAYMOND GEORGE SAINT
Credential	:	DC
Telephone Number	:	941-360-3434

Provider Enumeration Date	:	01/29/2008
Last Update Date	:	03/06/2008

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